HomeMy WebLinkAboutFilled Land Affidaviti
PLANNING & DEVELOPMENT SERVICES DEPARTMENT
Building & Code Regulations Division
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-5652
(772) 462-1553
FILLED LAND AFFIDAVIT
I, the undersigned, am the owner of the following described property,
3o13100 v 00V2
(Parcel Id#/Legal description/Address)
for which I have applied to St. Lucie County for a Final Devel nt Permit. In
accepting this Final Development Permit, BP Number r , I acknowledge
that as owner of the above described property, and in accordance with Section
7.04.01(D), St. Lucie County Land Development Code, I shall be responsible for assuring
adequate drainage so that the immediate community WILL NOT be adversely affected.
I further acknowledge that in granting this permit for the development of this property,
St. Lucie County is neither obliged nor liable to provide for, or maintain in any form,
adequate drainage off my property which will not adversely affect the immediate
community.
Property Oiner Name (Please Print)
Property Owner Signature Date
STATE OF FLORIDA, COUNTY OF Mah
ACKNOWLEDGED BEFORE ME THIS DAY OF Nl 1)y/ 120 1 1
BY WHO IS PERSONALLY KNOWN TO ME CW� OR WHO HAS
PRODUCED
SrGNAPE OF NOTARY PUBLIC
AS IDENTIFICATION.
L)S&- -1 Seri-4,K,1)
TYPE OR PRINT NOTARY
COMMISSION NUMBER
:.liar au'••• LISA JANE SERRD
�� Notary Public . StateCommission # GG My Comm. Expires NBonded through National N
SLCPDSD Revised 04/11/2011
(SEAL)